Organization
UNIVERSAL BEHAVIORAL SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. INDINAR BUFORD (VICE PRESIDENT)
(317) 684-0442
Entity
Organization
Contact information
Practice address
3590 N MERIDIAN ST, INDIANAPOLIS, IN 46208-4425
(317) 684-0442
(317) 684-0679
Mailing address
3590 N MERIDIAN ST, INDIANAPOLIS, IN 46208-4425
(317) 684-0442
(317) 684-0679
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221075
ANTHEM
IN
Enumeration date
07/13/2006
Last updated
08/22/2020
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